Southern Nevada Trauma System Plan February 26, 2015 Southern Nevada Health District ~ P.O. Box 3902 ~ Las Vegas, Nevada 89127 THIS PAGE INTENTIONALLY BLANK 2 TERMS AND ACRONYMS ACS -------------------- means American College of Surgeons ACS-COT ------------ means American College of Surgeons - Committee on Trauma ALS -------------------- means Advanced Life Support ATLS ------------------ means Advanced Trauma Life Support BIS --------------------- means Benchmark Indicators and Scoring tool outlined in HRSA Model Trauma System Planning and Evaluation Document Board ------------------ means Southern Nevada District Board of Health CDC ------------------- means Centers for Disease Control and Prevention COBRA --------------- means Consolidated Omnibus Budget Reconciliation Act DPBH ----------------- means Division of Public and Behavioral Health of the Nevada Department of Health and Human Services ED ---------------------- means Emergency Department EDAT ----------------- means Emergency Department approved for Trauma EMS ------------------- means Emergency Medical Services EMSTS/OEMSTS -- means Southern Nevada Health District Office of Emergency Medical Services & Trauma System EMTALA ------------- means Emergency Medical Treatment and Active Labor Act FARS ------------------ means Fatality Analysis Reporting System FEMA ----------------- means Federal Emergency Management Agency GCS -------------------- means Glasgow Coma Scale Health Officer ------- means Chief Health Officer of the Southern Nevada Health District or the Chief Health Officer’s designee HRSA ----------------- means U.S. Department of Health and Human Services Health Resources and Services Administration ICU -------------------- means Intensive Care Unit ID ---------------------- means Internal Disaster ISS --------------------- means Injury Severity Score MAB ------------------- means Medical Advisory Board MIS -------------------- means Management Information System NAC ------------------- means Nevada Administrative Code 3 TERMS AND ACRONYMS (Cont.) NRS -------------------- means Nevada Revised Statutes NTDB ----------------- means National Trauma Data Bank NTDS ------------------ means National Trauma Data Standard OPHP ----------------- means the Southern Nevada Health District Office of Public Health Preparedness OR --------------------- means Operating Room PAIS ------------------- means Bureau of Preparedness Assurance Inspection and Statistics PCR -------------------- means Patient Care Record PHP -------------------- means Public Health Preparedness PIPS ------------------- means Performance Improvement and Patient Safety PSAP ------------------ means Public Safety Answering Point QI ---------------------- means Quality Improvement RTAB ----------------- means Regional Trauma Advisory Board RTAC ----------------- means Regional Trauma Advisory Committee SNHD ----------------- means Southern Nevada Health District SNHPC ---------------- means Southern Nevada Healthcare Preparedness Coalition SNIPP ----------------- means Southern Nevada Injury Prevention Partnership TBP -------------------- means Trauma Bypass TFTC ------------------ means Trauma Field Triage Criteria TIIDE ----------------- means the CDC-sponsored Terrorism Injuries: Information, Dissemination, and Exchange Project TMAC ----------------- means Trauma Medical Audit Committee TRUG ----------------- means the Trauma Registry User Group 4 TABLE OF CONTENTS TERMS AND ACRONYMS .............................................................................................................................................. 3 EXECUTIVE SUMMARY .................................................................................................................................... 7 OVERVIEW ............................................................................................................................................................... 7 HISTORY AND BACKGROUND ............................................................................................................................ 8 KEY TRAUMA PLAN RECOMMENDATIONS ................................................................................................... 10 TRAUMA SYSTEM PLAN SUMMARY .......................................................................................................... 11 PLAN OBJECTIVES .......................................................................................................................................... 12 COMPLIANCE WITH STATE STATUTES AND REGULATIONS ............................................................ 13 AUTHORITY ........................................................................................................................................................... 13 DATA COLLECTION REGULATIONS ................................................................................................................ 14 ORGANIZATIONAL AND ADMINISTRATIVE STRUCTURE .................................................................. 15 MISSION STATEMENT ......................................................................................................................................... 15 AUTHORITY ........................................................................................................................................................... 15 ORGANIZATIONAL STRUCTURE ...................................................................................................................... 15 TRAUMA SYSTEM STRUCTURE ........................................................................................................................ 17 TRAUMA SYSTEM CHALLENGES ..................................................................................................................... 17 NEEDS ASSESSMENT ....................................................................................................................................... 18 TRAUMA SYSTEM DESIGN ............................................................................................................................ 19 SYSTEM MANAGEMENT .................................................................................................................................... 19 SYSTEM DESIGN AND OPERATIONS ................................................................................................................ 19 CATCHMENT AREAS ....................................................................................................................................... 25 OVERVIEW ............................................................................................................................................................. 25 FLEXIBILITY ......................................................................................................................................................... 25 TRAUMA BYPASS ................................................................................................................................................ 25 POLICY DEVELOPMENT ............................................................................................................................... 26 TRAUMA CARE COORDINATION WITH NEIGHBORING JURISDICTIONS ................................................ 26 TRAUMA CENTER FEES ....................................................................................................................................... 26 TRAUMA CENTER AGREEMENTS ..................................................................................................................... 27 INTERFACILITY TRANSFER OF THE TRAUMA PATIENT ............................................................................. 27 TRAUMA BYPASS PLAN ...................................................................................................................................... 28 DATA COLLECTION ........................................................................................................................................ 29 DATA SOURCES ..................................................................................................................................................... 29 REPORTING ............................................................................................................................................................ 30 TRAUMA SYSTEM PERFORMANCE IMPROVEMENT AND PATIENT SAFETY .............................. 31 5 TABLE OF CONTENTS (Cont.) APPENDICES: APPENDIX A: SNHD TRAUMA SYSTEM REGULATIONS SECTION 400: REGIONAL TRAUMA ADVISORY BOARD ................................................. 54 APPENDIX B: SOUTHERN NEVADA TRAUMA SYSTEM COMMITTEE DESCRIPTIONS ........................ 56 APPENDIX C: SNHD TRAUMA FIELD TRIAGE CRITERIA PROTOCOL ...................................................... 60 APPENDIX D: SNHD REGULATIONS, PLANS, PROTOCOLS ......................................................................... 66 APPENDIX E: DISTRICT PROCEDURE FOR AUTHORIZATION AS A CENTER FOR THE TREATMENT OF TRAUMA OR PEDIATRIC CENTER FOR THE TREATMENT OF TRAUMA ...................................................................................................... 67 APPENDIX F: DISTRICT PROCEDURE FOR RENEWAL OF AUTHORIZATION AS A CENTER FOR THE TREATMENT OF TRAUMA OR PEDIATRIC CENTER FOR THE TREATMENT OF TRAUMA ...................................................................................................... 69 APPENDIX G: DISTRICT PROCEDURE FOR TRAUMA BYPASS/INTERNAL DISASTER ........................